NRHA and coalition ask CMS to address wage index in IPPS rule
A coalition of the National Rural Health Association and state hospital associations is asking the Centers for Medicare & Medicaid Services (CMS) to address a Medicare wage index reform that would benefit individual states at the expense of others in the proposed Inpatient Prospective Payment System (IPPS) rule for fiscal year 2013. The hospital coalition group wants to reverse the health reform provision. Section 3141 of the Affordable Care Act (ACA) modified the "rural floor" adjustment for the Medicare reimbursement calculation as it relates to "work component" for PPS reimbursement. The "rural floor" and all calculations for the "work component" are done on a budget neutral basis; that is, when one hospital receives higher reimbursements, others’ reimbursements are reduced. Prior to the passage of the Act, this calculation was done within each state. The Act modified this calculation to require budget neutrality on a national level. This modification has opened the door for manipulation that will benefit individual states at the expense of others. The coalition is asking the CMS take administrative action to limit the ability of individual states to manipulate the intent of the rural floor at the expense of other states.